A, B, C… What is important to know about viral hepatitis

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An outbreak of hepatitis A was recorded in the Vinnytsia region in the fall, and it was eliminated in December. However, doctors will detect individual cases of the disease within 1-2 months.

There is also no guarantee that the outbreak will not occur again after some time. In addition, hepatitis A is not the only one of its kind, today you can make up a whole alphabet of hepatitises.

Therefore, “Ukrainian Pravda. Life” decided to find out:

• why did the outbreak happen?
• how dangerous is this disease?
• what is “hepatitis” anyway, and what is important to know about its viral types?

We tell you about it based on a conversation with a pediatric infectious disease specialist and the head of the National Technical Group of Experts on Immunoprophylaxis Fedor Lapiy.

What is viral hepatitis?

Hepatitis means inflammation of the liver. However, there are different types of hepatitis: they may not always be exclusively viral in nature. They are also caused by alcohol abuse, overdose of certain medical drugs, toxins, etc. There is also a type of hepatitis called autoimmune hepatitis: when our own immunity starts attacking our liver.

Different hepatitis spreads in different ways. Let’s talk about hepatitis A first.

What do we know about this disease?

• There is an effective vaccine against hepatitis A.
• Often outbreaks of this disease are associated with contaminated water, food and dirty hands.
• Hepatitis A is widespread in countries where there is a lack of modern sewage and other sanitary conditions.

What caused the outbreak in Vinnytsia?

As Fyodor Lapiy explains, there are several versions of what exactly could have caused the infection, but none of them are definitive yet.

“Contaminated water is most likely to blame for the outbreak. But there is no confirmation of this: water samples were taken for research, but the hepatitis A virus was not isolated“, the infectious disease specialist explains.

Hepatitis A can be suspected by the following symptoms:

• unusually strong fatigue and weakness;
• a sudden attack of nausea and vomiting;
• loss of appetite;
• dark urine;
• colorless stool color;
• joint pain;
• and the most striking symptom: jaundice, when the skin and sclera of the eyes acquire a yellowish color.

According to an infectious disease specialist, approximately 20% of school-aged children also fell ill during the outbreak in Vinnytsia region.

In general, the younger the child is, the easier it is for him to tolerate hepatitis A.

“Ukraine belongs to the countries of medium endemicity. This means that most of us encounter the virus and develop immunity after the encounter before reaching adulthood. But a considerable number of adults may not yet have immunity. But in highly endemic countries, for example, Africa and Asia, children under the age of 5 most often get hepatitis.”the doctor explains.

There is no specific treatment. Hepatitis A usually goes away on its own within a few weeks and rarely leads to death or irreversible liver damage. Although some patients may be ill for several months.

Time to move on our viral alphabet. And it is not possible to move on to hepatitis with such optimistic forecasts.

Read also: Hepatitis A outbreak: what you need to know about symptoms, complications and vaccination

Hepatitis B

What do we know about hepatitis B?

• There is an effective vaccine.
• 2 out of 3 people do not know they are infected.
• Hepatitis B is the leading cause of liver cancer.
• Because of this, it is especially dangerous for children under 5 years of age.
• Very stable in the environment.

Hepatitis B can pass easily and without consequences. And it can cause a serious chronic disease.

In order not to play such a lottery, Fedir Lapiy advises everyone who has not been vaccinated against hepatitis B to be vaccinated. This is especially relevant now, in times of full-scale Russian aggression.

We have higher risks of blood transfusions and surgeries, which are often the cause of hepatitis B virus infection.

How do you know if you have the vaccine?

Since 2000, the hepatitis B vaccine has been included in the National Vaccination Calendar of Ukraine. According to the Ministry of Health, the first vaccination is given to the baby in the first 24 hours of life. Three doses are required for guaranteed full protection.

Photo: Tharakorn/Depositphotos

For a long time in Ukraine, this vaccine (like many others) was surrounded by absurd and dangerous myths.

Major myth: Hepatitis B vaccine causes jaundice: yellowing of the skin and sclera of the eyes. It is caused by an increased level of bilirubin, a bile pigment that is formed as a result of the breakdown of red blood cells.

However, the hepatitis B vaccine does not even contain the virus to affect the liver in any way, says Fedir Lapii.

“The vaccine contains one single protein. This is a surface antigen that can be detected in the blood, but does not affect the liver in any way. But our immune system recognizes this antigen and thus forms a defense against an infection caused by the hepatitis B virus.”says the doctor.

He also adds that doctors who fall prey to this myth may also have played a cruel joke… the promotion of breastfeeding.

“In 2001, Ukraine received help from the Global Alliance to introduce a vaccine against hepatitis B. It was a Belgian-made vaccine. But this period coincided with the period of struggle for breastfeeding. And many doctors have forgotten what jaundice from breast milk is and what it looks like, or jaundice in breastfed babies. However, he falsely associated it with vaccination“.

Jaundice of newborns, as this condition is also called, occurs in the first weeks of life, when breastfeeding is not yet fully established and the child may not receive the necessary amount of milk for some time. This leads to increased bilirubin and jaundice.

Lapiy recalls how he explained the absurdity of this myth to his colleagues:

“Look, we are infected with the virus through an injection or sexually. There is such a thing as an incubation period. The minimum incubation period for hepatitis is 28 days. If jaundice and liver damage were related to the virus that is supposedly in the vaccine (and in fact it is not there), then these events should have occurred a month later, and not 3-4-5 days after childbirth. It was a revelation for some”.

Parents may mistakenly believe that if we contract hepatitis sexually or through blood, then babies are at low risk. However, this is also a myth: we cannot know whether a young child will need surgery.

Or will she find a used needle in the sandbox. And if a child under the age of 5 gets infected with hepatitis B, it will have a chronic form in almost 70-90% of cases.

And chronic hepatitis B infection is often the cause of hepatocellular carcinoma, the most common form of liver cancer.

An infectious disease specialist advises vaccination as soon as possible if such an accident as an injury by an unknown needle has occurred. This will help to significantly reduce the risk of infection.

There is a treatment for hepatitis B. People with a chronic form may be prescribed treatment with specific antiviral drugs. However, is treatment the best option for hepatitis B if there is an effective vaccine?

The symptoms of hepatitis B are very similar to the symptoms of hepatitis A:

• unusually strong fatigue and weakness;
• a sudden attack of nausea and vomiting;
• loss of appetite;
• dark urine;
• colorless stool color;
• joint pain;
• the most striking symptom: jaundice, when the skin and sclera of the eyes acquire a yellowish color.

Hepatitis C or the gentle killer

Such a poetic name for this viral disease did not appear for nothing.

The disease is almost asymptomatic, but the effect of the virus destroys the liver, which, in the end, may not cope with the performance of vital functions.

If the hepatitis B virus is very resistant and can survive in the environment for a long time, it is not so easy to get infected with hepatitis C.

However, if infection has occurred, a person’s life is in serious danger.

What do we know about hepatitis C?

• There is no vaccine against the disease.
• However, there is an effective treatment: 95% of cases can be cured.
• Hepatitis C is one of the main causes of liver cancer and liver transplantation.
• The main route of transmission: through blood or sexual contact.
• All people over the age of 18 should be tested for hepatitis C at least once in their life.
• It is important for pregnant people to get checked in the early stages of pregnancy.

According to the Ministry of Health, some people have no symptoms for years, while others may experience increased fatigue, sweating (especially at night), joint and muscle aches, loss of appetite and loss of concentration. Symptoms may come and go. In the later stages of the disease, when the liver is more seriously damaged, jaundice, itching, internal bleeding and constipation may occur.

Fedir Lapiy adds that itching is, in principle, a fairly common symptom of hepatitis and other liver diseases.

It is very important to start treatment against hepatitis C as early as possible. It usually lasts 8-12 weeks. Side effects of treatment are minimal.

In Ukraine, treatment against hepatitis C is available to everyone: therapy with modern drugs of direct action will cost 89 dollars. Thanks to this, all patients with hepatitis C who are waiting for treatment will be able to be cured free of charge. And this is certainly good news.

Photo: AlexanderPokusay/Depositphotos

These are not all letters of the alphabet that have taken viral hepatitis. There is also hepatitis D and E.

Hepatitis D has a very interesting nature. In fact, it can occur only in those people who are already infected with hepatitis B and have its chronic form. It needs the help of hepatitis B virus particles to start replicating (reproducing).

Usually, people are infected with either two viruses at the same time, or develop an infection after being infected with hepatitis B (superinfection). Currently, thanks to the success in controlling hepatitis B, doctors are also observing a decline in hepatitis D cases.

But here hepatitis E is mainly a problem of African and Asian countries. The way people get infected with it and the way the disease progresses is very similar to the course of hepatitis A. However, it poses a serious danger to pregnant women.

This type of hepatitis is quite rare in our country. A vaccine has been developed for the prevention of hepatitis E, which is registered in China, but is not yet available in other countries.

Natalya Bushkovska, especially for UP. Life

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